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Rural Health
Resources by Topic: Reimbursement and payment models

ACO Investment Model, Rural Hospital Collaboration
Highlights how 3 rural Minnesota hospitals implemented the Accountable Care Organization Investment Model (AIM), which encourages coordinated care in rural areas through upfront and ongoing Centers for Medicare & Medicaid Services (CMS) payments.
Date: 2016
Type: Document
Sponsoring organization: American Hospital Association Rural Health Services
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Rural Medicare Advantage Plan Payment in 2015
Examines how changes to the Medicare Advantage (MA) payment policy formula, which were implemented as part of the Affordable Care Act (ACA), are impacting MA plans and beneficiaries in rural and urban areas.
Author(s): Leah Kemper, Abigail R. Barker, Timothy D. McBride, Keith Mueller
Date: 12/2015
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Medicare Value-based Payment Reform: Priorities for Transforming Rural Health Systems
Analyzes the provisions within the Affordable Care Act (ACA) regarding Medicare payment and delivery system reforms that affect rural health providers and rural health services. Proposes recommendations that support the inclusion of rural appropriate payment systems.
Additional links: Policy Brief
Author(s): Keith Mueller, Charles Alfero, Andy Coburn, et al.
Date: 11/2015
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Which Rural and Urban Hospitals Have Received Readmission Penalties Over Time?
Evaluates the rural-urban differences in the proportion of hospitals that receive penalties under the Centers for Medicare & Medicaid Services (CMS) Readmission Reduction Program, and compares the specific health condition risk-adjusted readmission rates by rural and urban location. Analyzes characteristics of hospitals receiving readmission penalties.
Author(s): Peiyin Hung, Michelle Casey, Ira Moscovice
Date: 10/2015
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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State Actions to Promote and Restrain Commercial Accountable Care Organizations
Identifies actions state governments can take to promote the benefits of Accountable Care Organizations (ACOs) while mitigating potential risks. Discusses rural-specific concerns related to solvency and exclusivity provisions. Also examines state policy tools that regulate and support both providers and payers. Section 2 offers ACO policy guidance specific to California.
Author(s): Nicholas C. Petris Center on Health Care Markets and Consumer Welfare
Date: 10/2015
Type: Document
Sponsoring organization: University of California - Berkeley
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Rural Delivery System Reform Takes Center Stage for National Advisory Committee
Reports on discussion at a September 2015 meeting of the National Advisory Committee on Rural Health and Human Services focused on the need for rural healthcare providers to be involved in health system changes related to payment and service delivery.
Author(s): Kate Menzies, Brandon Baumbach
Citation: Rural Monitor
Date: 10/2015
Type: Document
Sponsoring organization: Rural Health Information Hub
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National Advisory Committee Tackles Delivery System Reform, Child Poverty
Describes a September 2015 meeting of the National Advisory Committee on Rural Health and Human Services held in Mahnomen, Minnesota, which focused on rural child poverty and healthcare delivery system reform.
Citation: Rural Monitor
Date: 10/2015
Type: Document
Sponsoring organization: Rural Health Information Hub
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Hospital Value-based Purchasing: Initial Results Show Modest Effects on Medicare Payments and No Apparent Change in Quality-of-Care Trends
Evaluates the initial effects of the Hospital Value-based Purchasing (HVBP) program on Medicare bonus payments and penalties, the quality of care provided, and selected quality improvement efforts during FY 2013-15. Analyzes data from safety net, small urban, and small rural hospitals.
Additional links: Full Report
Date: 10/2015
Type: Document
Sponsoring organization: Government Accountability Office
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Rural Hospital Toolkit for Transitioning to Value-based Systems
Toolkit developed to help rural hospitals improve their financial, operational, and quality performance. Shares best practices and strategies to help rural providers transition to value-based payment and population health.
Date: 09/2015
Type: Website
Sponsoring organization: National Rural Health Resource Center
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Performance Measurement for Rural Low-Volume Providers: Final Report
Identifies challenges to measuring healthcare performance among low-volume rural providers, and presents recommendations to meet these challenges. Primary focus is on finding appropriate quality measures for use within Centers for Medicare and Medicaid Services' (CMS) pay-for-performance programs and encouraging rural participation in CMS quality improvement initiatives.
Date: 09/2015
Type: Document
Sponsoring organization: National Quality Forum
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